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Effect of an Upper Body Flexibility Intervention on Neck Range of Motion in Older Women

The purpose of this study was to determine if a flexibility program could improve the range of motion of the upper body and in particular neck rotation.

Michelle M. Porter, Faculty of Kinesiology and Recreation Management, University of Manitoba; Sandra C. Webber, Dept. of Physiology; Heather D. Klassen, Faculty of Kinesiology and Recreation Management, University of Manitoba, Canada; Nancy Maskus, Faculty of Kinesiology and Recreation Management, University of Manitoba, Canada

Neck flexibility is important for many daily tasks. Crossing the street while walking requires a high amount of neck rotation. Backing up a vehicle while looking out the rear window requires the greatest amount of neck rotation among typical daily tasks. Many older adults have reduced neck rotation range of motion, and therefore some may be limited in their community mobility, including driving a vehicle safely. Flexibility programs have been recommended to improve neck range of motion, but the research evidence for this is limited. The purpose of this study was to determine if a flexibility program could improve the range of motion of the upper body and in particular neck rotation.

Older women (70 and older) with self-reported mobility limitations were randomly allocated to 3 exercise groups: upper body flexibility, lower body power training with elastic bands, and lower body power training with resistance training machines. The latter 2 groups were control subjects (n = 33) for the upper body training intervention subjects (n = 15). All subjects exercised for approximately 45 min twice weekly for 12 weeks with the same warm up and cool down protocol. Upper body flexibility training consisted of the following static stretches: trunk side flexion, shoulder retraction and protraction, neck side flexion, neck rotation, forward neck flexion, neck retraction and diagonal neck movements. All stretches were done 3-4 times and held for about 10 s. In addition, 2 dynamic range of motion exercises were done including shoulder and arm circles (forward and backward).

Testing of upper body flexibility (by a blinded assessor) included field tests of neck and trunk rotation as well as shoulder flexibility. The "back scratch" test of the Seniors Fitness Test was used to measure shoulder flexibility. Neck range of motion (side flexion, forward flexion, and rotation) was measured by the Cervical Range of Motion (CROM) device. Two way repeated measures analysis of variance was used to test for changes between groups for each of the flexibility variables. None of the range of motion measures showed differential changes in the intervention group versus the control group after training, except for the back scratch test.

In this test the flexibility trained subjects improved on average by 4.6 cm (p < .01), whereas the control subjects did not change (only increased by about 0.2 cm on average, NS). Reasons for the lack of a change in neck rotation range of motion may be because stretching may not be able to overcome the age-related changes that limit rotation. In contrast, shoulder flexibility may be more amenable to change because of the larger soft tissue components as compared with neck rotation. Alternatively, improvements in neck range of motion may require relatively more frequent training (more than 2 days per week). In conclusion, this study found that while shoulder flexibility was improved with an upper body flexibility program twice weekly, neck range of motion was not. Support for this study was provided by NSERC, CanDRIVE, and a fellowship to S. Webber from the Institute of Aging, CIHR.

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